Thursday, September 01, 2011
Pain is hard for doctors to treat

By Dr. Anthony Policastro

Pain is a common complaint in medicine. Unfortunately, it is not easily measurable. We can measure blood pressure, cholesterol levels and blood sugar which allow us to decide if our treatments are working. The same thing is not true about pain which is something patients have to describe. They have to tell us how severe it is and whether the treatment is working or not. As a result it is sometimes difficult for the physician to decide what kind of treatment to use. This leads to sometimes providing too much treatment and other times, too little. Neither of these approaches is desirable. In either case it can lead to an unhappy patient. Some patients feel that they are not receiving enough pain medication. Since there is not a number for the doctor to measure to know for sure, the doctor has to take the patient's word for it. The doctor tries different medications, different doses and different combinations. The medications might help make the pain go away. Or they might make the pain less or feel different. Each patient will have a different reaction. For that reason there is no formula for deciding what the right treatment is. Patients do not always understand this and they get upset when they do not get better quickly. At the other extreme are patients who feel that they have received too much medicine. The physician is often guessing at the correct dose. The result may be a dose that the patient feels is too high. It might be a drug that causes side effects or a mixture of drugs that do not go well together. Again there is no real formula for deciding what is right. Frequently the patient is not the one to complain about possible overuse of medication. The complaint may come from a concerned spouse, parent or child. In each of these cases, the individual knows the patient better than the doctor does. They have a feel for how much pain the individual is in. They can see how it affects everyday activity. The doctor does not have that kind of insight which is impossible to get during a brief office visit. There is clearly a dilemma for the treating physician. He/she might be accused of giving too much medication or too little. The only thing to measure is what the patient says the pain feels like. Treating patients with chronic pain is difficult. The easiest thing to do is to decide to not treat this kind of patient. Many physicians will refer patients with chronic pain to pain specialists. Complaints are more common for these physicians. Some are accused of under-treatment, others over-treatment. Unless we find a way of more objectively measuring pain, this will continue to be a long term problem for both the doctor and the patient.

How to prevent mold, safety risks

Water intrusion creates a variety of health and safety risks for families. Flooding and leaks are a leading cause of mold growth in homes. Flooding also puts water in dangerous proximity to electricity, creating risk of electrical shock. Delaware's Division of Public Health offers the following recommendations to head off this growing problem.

  • Check outside cellar walls for possible cave-ins, evidence of structural damage or other hazards. Consider hiring a licensed structural engineer to evaluate your residence.
  • Run dehumidifiers and empty the water pan frequently, or empty directly to a sump pump, to lower the humidity and help prevent mold and odors.
  • Open doors and windows or use blowers to force in fresh air to remove odors once the home is dry.
  • Do not use an electric pump powered by your own electrical system. Use a gas-powered pump or one connected to an outside power source. Fire departments in some communities may help with such services. Ventilate the area to prevent buildup of carbon monoxide gas.
  • Before beginning clean-up, protect yourself with an N95 respirator, gloves and eye protection, available at most hardware stores.
  • After water has been pumped from the basement, shovel out the mud and debris while it is still moist. Hose down walls to remove as much silt as possible before it dries. Floors and walls may need sanitizing, particularly if sewage has entered the basement. Scrub walls and floors with a 10 percent bleach solution or other comparable commercially available disinfectant.
  • Oil stains in basements caused by overturned or damaged oil tanks may be a problem following flooding. Call a professional to remove oil residue.
  • Dealing with garbage and sewage can be challenging. If toilets aren't working, use portable units. Beware that sewage can backflow through floor drains into basements. Clean with a disinfectant. Never mix ammonia and chlorine bleach, which produces poisonous chloramine gas. After coming into contact with sewage or floodwater, wash your hands well and use a brush to clean under fingernails. These precautions will make your clean up tasks safer and keep you healthy.
For more information or other public health concerns, contact the Division of Public Health at

Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program.The location rotates each week of the month throughout Sussex County. "New Beginnings" luncheons are open to the public. Registration is not required.There is no fee except the cost of your lunch. For more information, call Midge Dinatale or Paul Ganster at 856-7717.

Alzheimer's Support Group Nanticoke Memorial Hospital's next Alzheimer's Support Group meeting is at 1:30 p.m. on Tuesday, Sept. 13, at LifeCare at Lofland Park's first floor resident lounge, 715 E. King St., Seaford. This group provides support and information about Alzheimer's and dementia to families, caregivers and anyone who is affected by this disease.Refreshments will be provided. Pre-registration is not required.For more information, contact LifeCare at Lofland Park at 628-3000, ext. 8302.

Extension offers food safety classes The University of Delaware Sussex County Cooperative Extension office in Georgetown will offer two different levels of food safety instruction, ServSafe on Sept. 14, and Dine Safe on Sept. 21. Workshops will be held at the Elbert N. and Ann V. Carvel Research and Education Center in Georgetown.

Both ServSafe and Dine Safe are appropriate for any individual who works in the food industry (restaurant, church cafeteria, school) or who handles, prepares and serves food to the public. The ServSafe program is the premiere food safety certification offered by the National Restaurant Association Educational Foundation (NRAEF). The program is designed for the food-service professional. A ServSafe certificate from the NRAEF will be awarded to individuals who complete the course and receive a passing grade on the exam. The cost of $150 for the course covers the training, textbook, lunch and certification examination from the NRAEF. A reduced course fee of $130 is available for three or more registrants from one establishment. A ServSafe certification is valid for five years and is nationally recognized. Delaware Dine Safe is a 3-hour short course designed to focus on the basic principles of food safety and handling. All participants will receive a certificate of participation. The Dine Safe short course is $25 and can be scheduled at a business location provided there are at least 10 employees enrolled. ServSafe will be taught on Wednesday, Sept. 14 from 9 a.m. to 5 p.m. Registration deadline is Aug. 23. Dine Safe will be offered on Wednesday, Sept. 21 from 6 to 9 p.m. Deadline to register is Sept. 14. For more information, visit, or contact Michele Walfred at 856-2585, ext. 550.

NMH offers first aid classes Nanticoke Memorial Hospital will offer community First Aid classes to anyone interested in learning first aid from 6:30 to 9:30 p.m. on Tuesday, Sept. 13, at the Nanticoke Training Center located on Water Street in Seaford.Participants will learn basic first aid that will enable them to administer help during the first few moments until emergency responders arrive. Classes are open to participants 13 and older. The course covers cognitive learning, role-playing and skill practice. Cost is $30. Payment and registration is required by no later than five business days before the class. Late registrations (if seating is available) will be an additional $5 fee. To register, or for more information, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919.Pre-registration is required.

Dr. Kornfield joins NHS Nanticoke Health Services (NHS) welcomes Elizabeth Kornfield, MD to the Nanticoke Physician Network. Dr. Kornfield specializes in urology and is accepting new patients at 24488 Sussex Hwy., Ste. 2, Seaford. The practice will provide services for a number of conditions including prostate, bladder and kidney cancer, kidney stones, urinary tract infections, sexual dysfunction, pelvic pain, urinary incontinence and pelvic organ prolapse. Dr. Kornfield completed her residencies in urology and surgery at the New England Medical Center in Boston, Mass. She comes to Delaware from Arizona where she practiced for more than 10 years. Dr. Kornfield is fluent in French and is a member of the American Urological Association, the Society of Women in Urology, the American College of Women's Health Physicians, the Society of Urodynamics and Female Urology and the Maricopa Medical Society. To make an appointment with Dr. Kornfield, call 629-4299.

Prostate screenings offered In honor of Prostate Cancer Awareness Month in September, the Cancer Care Center staff at Nanticoke Memorial Hospital will provide prostate screenings on Friday, Sept. 16 from 8 a.m. to 5 p.m., in the lobby of the Miller Building, located at 121 South Front St., Seaford. There is a $5 screening fee and pre-registration and fasting are not required. Nanticoke Memorial Hospital encourages men over the age of 50 to take advantage of this service. Men who are age 40 and at high risk of developing prostate cancer are also encouraged to participate. African-American men and men who have a family history of the disease have a higher risk for developing prostate cancer. For more information, call Melinda Huffman, nurse navigator, at 629-6611, ext. 3765.

Stroke Support Group offered Nanticoke Memorial Hospital's next Stroke Support Group meeting is Tuesday, Sept. 20, 1:30 p.m. at the Seaford Library.This free support group is designed for individuals who have survived a stroke as well as their families and caregivers. Modeled from the American Stroke Association, the hospital is engaging with speakers to provide education, community resources and emotional support to those who have been affected by this life-altering event.The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support, and allow for networking. Refreshments will be provided. Pre-registration is not required.For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Free prostate cancer screenings Bayhealth Medical Center will offer prostate cancer screenings free to those who qualify during Prostate Cancer Awareness Month in September. These screenings are part of Bayhealth's continuing efforts to educate the community and help people identify cancer in its earliest, most treatable stage. Prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of cancer deaths for men according to the American Cancer Society. Annual screenings are recommended if you're a man over the age of 50, or over the age of 40 with a family history of prostate cancer in a close relative diagnosed before age 65. African-American men are twice as likely to die from prostate cancer and should begin screenings at the age of 40. The Bayhealth Cancer Institute is providing prostate cancer screenings which consist of a prostate specific antigen (PSA) blood test, and a digital rectal exam (DRE). The screenings are free to those who qualify but pre-registration is required no later than one week before the screening. For any questions, and to register, call 430-5064 or 744-6752. In Milford, screenings will be held from 9 to 11 a.m. on Saturday, Sept. 17, at Bayhealth Cancer Center located at 21 W. Clarke Ave.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.